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April 18, 2006 -- The herbal medicines devil's claw, white willow bark, and cayenne might reduce back painback pain, according to a new research review.
But the review's authors aren't recommending those herbal remedies. Instead, they say more work is needed to sort out the risks and benefits of the herbal treatments.
The review was conducted by researchers including Joel Gagnier, ND, of Canada's Provincial Medical Centre in Windsor, Ontario. Gagnier and colleagues reviewed 10 studies with a combined total of 1,567 adults with acute, subacute, or chronic low-back pain.
Those studies were done by various research teams. Gagnier and colleagues checked those studies' methods and results, publishing the findings in The Cochrane Library.
Review's Findings
The review showed that standardized daily doses of 50 milligrams or 100 milligrams of devil's claw, taken orally, seemed to reduce back pain more than fake pills (placebo).
A 60-milligram daily dose of devil's claw also appeared to cut back pain as much as a 12.5-milligram daily dose of Vioxx, a painkiller no longer on the market due to a rise in the risk of cardiovascular events -- such as heart attackheart attack and strokestroke -- in some patients.
Daily oral doses of white willow bark -- at 120 milligrams or 240 milligrams of white willow bark's active ingredient, salicin -- were also found to reduce back pain more than a placebo, the review shows.
Cayenne, tested as a plaster applied to the skin, appeared to reduce back pain more than placebo. Cayenne plasters also equaled -- but didn't surpass -- results for a homeopathic gel.
Quality of Studies
Gagnier and colleagues call the evidence for devil's claw "strong," compared to "moderate" evidence for willow bark and cayenne plasters.
However, the review also expresses concern about the quality of some of the studies. Gagnier's team also found possible conflicts of interest in six of the studies, which may have biased those studies' results.
All of the studies were short, lasting up to six weeks, so they don't show long-term results. Additional high-quality studies are needed, Gagnier and colleagues write, adding that herbal medicines can vary in preparation and content.
Meanwhile, the web site of the National Center for Complementary and Alternative Medicine (NCCAM) offers this general advice for people considering any type of supplement:
SOURCES: Gagnier, J. The Cochrane Library, 2006; Issue 2. National Center for Complementary and Alternative Medicine: "Herbal Supplements: Consider Safety, Too." Health Behavior News Service.